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` f �� CITY OF DIAMOND BAI+� � DEPARTMENT OF COMMUATITY 1�DEVELOPMENT SERVICES ,�� 21660 E.Copley Drive Suite 190 (909)860-3195 Fau(909)861-3117 PRESS ����'�� BUILDING PERMTT APPLICATION FIRML oJOBSITE ^� /' C APPUCATION � 3 66 NUMB R �J �� M/C ADDRESS O!��j�� V''13/�1%sfJ ���I"/i�Y�•�c DATE $ ISSUE G TYPE OCC APN LOT TRACT DATE a �� CONST. GROUP �j OWNER _�_���J i'�� C,e��C� � ADDRESS !r'/J-L��1! -- , ih1 ZONING SETBACKS Z CITY ZIP TE - FRONT RW O g APPLICANT 7 ..'';� . REAR ❑ � SIDE/SIDE STREE7 RW ❑ CONTRAC70R ��=f�� C//a� SIDE ❑ � ADDRE S • -�U 1.1m!��-�- C(TY�� lICl�12' 21P `/'/�'l'7'TEL��<<�L�''iS�� PROPOSED USE � ARCH/ENG! DESIGNER NO.DWEL NO. NO. ADDRESS UNITS STORIES BEDROOMS � CffY ZIP TEL � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER•BUILDER DECLARATION SFR/ADDlREM O p 1 HEREBY AF'FlRM UNDEH OENALTY OF VEIWRY h1AT I AM EXEMM FROu THE GO17�RACTOHS L4 ,Gefeg9/CeryOR . . W CENSEUWFORTHEWLLOWHOREASONISEG7D71.6BUSWESS+IN�PROFESSIONSCOOEANYCRYOR (n � 001flTYVM1#tl111E0UIRESA0ERAIRTOCONSTitUCT,IITE0.M�vROVE,Cf1AOLI5H2ORREF�IRM1Y57RU0. W palio/Deck � � � � 7URE RiqR 70 R9ISSUANCE.ALSO REOUIRES TNE MPLICANT FOFi SUCH PERMIT TO fM1E A SIGNED W � STATE4ENT THAT HE OR 8HE IS UCENSED VURSUANT TO iHE PROVISIONS OF THE CONTRAC70RS t4' � CENSE UW I�hR Y�COMMENCW4 N17H SECTiON 7Da0)Of OMSION 7 OF'7HE BU9MESS AND FRO- �-' PooUSpa FESSIONS CODE)��T NE OR SHE tSIXEMVT THEpEFROAI AND THE&1513 FOfi l/¢ILLLEDEO EXEMP• TqN.AH'lYIOIATqNOFSECT10N7W1.6BYANYAPVLICANTFORAPEIWITSUB.lECiSiHEAPPLICANTTO Z RaRoof � A CIVIL OENALTV OF N�T YONE TUN FNE HUN�RED DOLIARS({500).1: ! � OIASOWNEHOFiHEPROFEATN.CNMYEMPIOYEE3VATHWAGESASiNEIRSOLECO�PENSATION, � CORIrtI0fCL31 MALL DO TNE WORK,AND TME STRUCi11RE 6 NOT IMENOED OR OFFERED FOR SALE(SEC 7oN,BU54 J NESS NM GROFESSIONS CODE:TNE CONTMCTORS LICENS[Lnw DOES NOT AGPIV TO AN OWNER OF N ifpPEqTYYh10BULOSOfiMPqOVESiHEN[ON,ANOWHODOESSUp1MJONKNIMSEIFOflMERSEIFOR = Q 7Hi10t)O/iMISORHEROWNfA1PLOYEE3,PROVIDED'�UTSUCH�A7ROVEMENTSARENOTMITENDEOOR m l�J pFFEpmppqghLEIF1pWEVERiHEBULpPMORWPROVEMQJT44501DWR14NONEYEAftOFCOMPLE• ZTIOH,THE OMT1ER�eURDER MALL H�YE THE BUROEN OF GHOVIN�T1AT HE OR SHE 010 NOi BUILD di = W PiqVE FOR TIIE PURPOSE OF 9ALE} W OI,ASOWNEROFTNEVPOVERTY,IWEXClUSNEL�COMMC71NO1MfTMUCENSEDCONTMCTOR3 � it�CONSTRUCT 7HE VRO.IECT(SEG 7DN,OUSME53 AND PHOFESSIONS COOE:THE CONTMCTORS LI- V01UalI0f1 ADJ.AREA CE16E UW DOE9 NOT MPLY TO AN OYMER OFA PROPERT7 YMp BUM1DS OR MFRDVES TMEREON,AhD NRqCONTMCTSFO115UpIPR0.7ECfSNATHACONTMCTOR(SjIICENSEDOURSUAMTT07NECONTMG pUANTIN DESCRIPTIO� FEE � � TU0.5l10ENSEUW.1. . , OIMIE7(EMPTUNDERSEG B.IG,GGOHTHI5REA50N U _'If� US I � LL' DATE OriNER � � W LICENSED CONTRACTORS DECIARATION —� � w IHEREBYAFFGWUNDERPENALTYOFVEiWMT11A71AMUCENSEDUIIDEFVROVI5lON50FCHADTER Vr s ��COMMENCNO WIiM SECTION 7aCa)Of DMSION 70F 1HE BU51HE55ANO PROFE55�ON5 CODE,AND Z YC W IICENSE IS IN FIAI FORCE D EFiECT. r m � UCENSE CLASS ", UC.NO.�!,� / `''/ � � o�� ��Z—O,/� - -- carr�ucroa a �W � �� d WORKERS'COMPENSATION OECLARATION � � U N INER[HYAFFlRMUNDERGENALTYOFPEMIRYONEOFMEMLLOWW6DEMMTIONS: � ZQ G .p_IINVEANDN�LLMANTNNACERiIFIG1TEOFCONSENTTOSELF-INSUREfORWONKERS' S 1 I L� L � � tCMPENSATqN,A3GROVIDEDBVSECT10Nf7o00FTHELAU0i1CODE.FORTHEVERF011MANCE U � Q OFTME WORK FOH MA1K]17MIS YERMIT IS ISSUEO. � � T � _IHAVEANDWILLMAtlfTAINWORKEFiS'COMPENSATpNINSUNANCE,ASREWIREDBV5EC710N G�D SAFETY Q 770o OF THE LABOR tOOE FOR THE PERFOM.UNCE OF THE WORK FOH WHICH TNIS PERAIR IS L i�L�]7�� � ISSUEO.WWORKE0.:CWPENSATIONINSUfUNCEGARIERANDPOIICYNUMBERME CON T�UVI7GM� - j GARIER PLAN REVIEW � pOUCYNUABER ELECTRIC p �ssEerqnr�IDrqr¢eop,s�hpocnEvewnrrstana+��ouooalNtsR+oolcr++ttssl PLUMBING /�, Z ICER7IFYTIATNTHEPERFORAIANCEOFTNEWOi1KFORWMIp1TH157ERMITIS�SSUED,I MECHANICAL L'`'9 �XLI (,�} 6FLVINOTEMPIOV/UJYPERSONWANYYANNERSOASTOBECOYESUBJECTTOTH[ � WORKERSGOi.�PEN5AT10MUW50fCNJFOFVIIA.ANOAGREEiNATIF1511IXAD8ELOME INSPECTIONFEE c SU9JECTTOTMEWORKEi15'CdAPENSA710NGRONISIONSOFSEC710N�7000F7NElABOR ISSUANCE ,/. OG E.I&WLFORT)YIWITMCOMPLYWIiHTlb E SION4. `/`_ / pDATE: `�L APPLICANP.__�%�F.. V'���T(J/�L�/ �SMIP � . W ENERGY P!C � WARNIHO:fAILURE TO SEd1NE VA1U(EAS'COYPENSAT�ON COVERA('+E�5 UNUWFUL.MID SHALI,DE SUBJECfMIEMPLOYERTOCRIIAtNJLLPENALTIESANDCNILFWESUPTOONEHUNDREDTHOUS/fID ENERGYPERMIT OOLUAS�f700.OD0�N AODITION TO THE GOST OF OD6�PENSATqN,DAMAGES 113 PROVIDED FOH IN ¢ 6ECT1ON�7oeOFiHELABORCODE,INiEREST,IW0A7TOiVJEYSFEEi. RETENT�ONFEE: a CONSTRUCTION LENDIN6 AGENCY PRE-ALT FEE: O � INEHEBVIiFFIHMUNDERPEN�LTYOFfE0.1URYTIUTTNEREISACONSTRUCTIONLENDINGAC[NCY � FOiiTNEPERFORMANCEOFTHEWORKFORN'MIp1iHISFERM1TI5155UED�SEGJ0i7,GV.0.�. ' � � LENDER'S NAME � LENDER'S1lDDNE55 . , ICERTIFYTUTIIUVERE�DTHISM7LIG7�ONMl�STATETNATiHEABOVENFORMAT10NI5CORRECT. TOTAL FEES �� ,� O O � IA(3REETOCOr.�7LYVATHALLLT'ANDCOUNTYORDwANCESANDSTATEUwSPEIATNOTOBUILDtNO ! CONSiqt,CTION./�HD HEREBV AUiHORRE REVRESENT�TNES OF THIS COUNN TO ENTER UPON TT1E ZABOYE�MENTNN DFROVERTYFOFINSPECTqNPURP06E5. COMMENTS � � _ ��J� � 4 PERMI E(VR � � �, . -3-vd y SIONA7URE YERMITfEE DATE � RECPT.N0. �'�.�,5 PND BY VALIDATION WHITE—Depertment Capy.YELLOW—Finence Copy,PINK—Aseessor Copy.GOLDENR06—Fite Copy.GREEN—Appicanfs Copy .. , . ,.. , ..� } '.i`. '�, � . . ' .. . � '�� . .. .... ,. . . . . , ' . . ..... .. . .... .,4.r.�r e � on •�, ., ' � CITY OF DIAM�JND BAR , ..,., , � � , ..,�, 1��1SPECTION RECORD ' :'� . - � . ; . . ., . , �.��fi�l�.�..,,,�{d ' � �r B �.��-� . e .... � ,.�,_ � . ..�°3`�°,"�__.. i �SET BACK•�: . � ,r•, i ;;i .,:. c; I ' ' FLOOR JOIST � . - - ; FfGS/FORMS/STEEL � ' � � ; � ; , .-; FHA REQMTS '.. . ;ELECTRIC GROUND . . .� '�% 1 �.; - UNDER FLOOR DUCT,- ' � ' ' GR�UND PLUMBING � � UNDER FLOOR CO�IDUIT" �-� � � •� ' " ' , . , . _ . , -;— '.SLAB GRADE - -- �' ' ' FIREPLAGE�dZ1t�DATION .� � ' ;TEPAP POWER . _ FIREPL.��G'E�BDND BEAM - • f �WATER SERVICE • - - - ' MID HT. BOND BEAM �'' � � - ' � � !ROOF SHEATHING ' � ` � . - £i FT.BO�1D BE�IM. - - .'•.,. -- � 'FRAMINGNENTfLIATiON ' � ` '� FINAL'BOND BEAM` � '� � � ; ;:' 'ROOFCOVER � PRE-GRADING ' ; 'ROUGH HEATING -- - - - ' BENCHING �ROUGH ELECTRIC _: . . .'' ROUGH GRADING � � ;ROUGH PLUMBING ' - • ' FINISH GRADING '•SHOWERITUBTEST '� - - - ' - •, POOL'ELECTRIC ' �EXT. LATH/SIDING :- . - - _ . POOL'FENCING WALL INSULATION � � POOL'FINAL � ? , �CEILING INSULATION " - - � ' OFF SITE IMPS. i ;DRYWAC.LNAILING � ' - DEDICATIONS• ' ;SEWER FINAL�ENG: ISEPTIC TANK LANDSCAPE/IRR1G. ' , �SEEP PIT/L.L. .. ON SITE IMPS. 'GAS f+�R TEST � i FINAL ZONING j �. FINAL:CONST...... . ', ' .._'� , FIRE DEPT. FINAL F1NAL HEATlNG , . � � ' � . . HEALTH DEPL FINAL ' ' ' ' DEV. FEES PAID �FiNAL[LECTRIC - - �E'IrJAL�PLUMBiNG- � � ENERGY � Rw'1��1�!'1+�rR�y'i�7!'R��"..'�"^^'�' ' , . . _. . ... ;�� ,rl�C,r..,�, .'43 L Qw• ,,. _ �. .,.7�iir..�..,'L.�1��. L.�w..��'�:.5.�..J:� ._.._. . .. . . . . ." _' . .. . . . � , - . . � . . 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